Palmoplantar pustulosis-any tips for daily life?

Hi McJu So sorry you have been diagnosed with this. I’ve been living with mine now for about 4 years. drs kept trying me on different creams etc and I always had hope it would go but I’m still here living with it. From doing some research on here, I discovered beta blockers could be what causes an onset, which is what I had been taking, but the dermatologist told me it was probably a coincidence. Some coincidence! Probably covering the pharmaceuticals’ backs. Anyway I came off them praying it would go but it didn’t, although it has got much better and I don’t get it on my hands anymore. I came off all medication after that and I think ibuprofen causes it to flare up. I also stopped smoking. And I now try to limit sugar in my diet which I also think helps. I also underwent PUVA treatment which has healed my skin to a point where it’s much more manageable. I kept popping the blisters as soon as they came, as someone suggested and I think this helps. It took a long time before they actually referred me to the dermatologist. They offered medication but I don’t want To have to live with some other side effect! It’s a horrible, embarrassing condition which is really hard to talk to people about so I hope you find some comfort here in knowing you’re not alone. It’s really affected my confidence and if I think about the future living with this it really gets me down. I hope they find something better than what’s already on offer for all of us suffering with this. Good luck to you on getting the support you need.

Hi PussOff, just to say that I'm sure Ibuprofen causes mine to flare too... (the dermatologist was doubtful, but my evidence supports my thinking) and that sugar is a major culprit also, although i'm finding it, and smoking, very difficult to completely give up! Anyway, good luck to you and us all ..

I was diagnosed with this condition 20 years ago I went through light treatment which never helped ,tried all the creams that were prescribed and they never helped ,eventually started taking Biotin every day ,gradually the condition started to get better, it took about three months to completely disappear I have been completely symptoms free since then I still take the biotin but only about once a week now and I have no symptoms

I have had this condition for over 2 years now, which was triggered by a drug called humira a biologic treatment for my psoriatic arthritis, I had a massive reaction to this causes extreme blisters, hives, swelling, phuemonia and put me in hospital for weeks. They put me on dermovate cream which had to be put on very generously and had to have the blisters drained, well after the blisters started to go down the scaly skin is left, so I found none of there moisturizers very good so started using coconut oil which is brilliant and I went about 2 years with clearish skin, I now have blisters coming back and doctors dont know if it's the new biologics causing it or not but rheumatology want to increase dose for my bones, so we will see. Anyway has anyone found shoes that are comfy and allow your feet to breath because my work require me to wear closed shoes/ trainers that are able to withstand vigorous cleaning as I work with needle and blood and have to be black?

Hi speckie just read your post. Biotin worked for you! I’ve had ppp for over 5 years and nothing has helped so far. I was prescribed various creams from the doc at the hospital. Did the light treatment etc nothing has helped so far but I’ll try the Biotin it’s worth a go. I quit smoking a couple of months ago and would you believe it’s worse especially on the soles of my feet. Has anyone’s fingernails been damaged by it?

Ive suffered with this for years. My hands could be cleared up but not my feet. I found a way to clear it up without any medications. Let me say how. My doctor kept suggesting that i try Sun therapy. 6 months of the year where I live is often covered in snow so thats not an easy task. Last year I went camping and spent a good amount of time swimming and the bottom of my feet actually got a decent amount of sunlight which did a decent job clearing up my breakout. But summer ended and the weather got cold so repeating that more then 3 months of the year isnt feasable. So about a month ago, I was back at the Dr. Looking at more unfavorable medications with not so nice side effects. A few days after that I asked my friend if he would build me a box with a glass top. In the back theres a slot for a light bulb. I took one of my natural light Full spectrum UV bulbs in the box. For 15 mins a day, I put my feet on the glass of the box and turn it on. It only took a few days to see a difference in my breakout. Now a month later my skin is almost completely healed. Its still a little thick but my pumace stone in the shower clears up all that dead skin. Ive been reaearching ways to clear this up for over 10 years. And seeing people spend hundreds a month on medications, I cleared this up with $30 worth of supplies. If I could post pics of how this was built I would. But I can say what a miracle something soo simple is. I hope this helps someone because its really been a godsend for me. I am sure I dont need to explain how miserable this condition can be. This is an easy and cheap chemical free fix.

Hi I have PPP for about 10 years,, but its very intermittent.. What makes it flare up for me is 1.. long haul flights. 2. hot weather If on a long haul flight I drink half a litre of water every hour, this cuts down the impact 95% If I am somewhere hot and sunny and forget to top up with water, it explodes, even if its 4hrs. What I have deduced is that I have no or very low thirst mechanism. I can play tennis or soccer for an hour or run 10k and nope nothing.. So if I forget to drink, I get another flare up. It's 99% on soles of my feet and 1% on my hands, almost negligible. I have never smoked but grew up in a home where both parents chainsmoked. So lungs smoke free for 40 years.. Not too obese, 6 feet and 200 poinds perhaps 5% too heavy. Drink half a dozen beers a week. I am a financial auditor/accountant and my job is to look for patterns trends etc but basically sit in front of a pc all day So my conclusion is mine is triggered by dehydration and if I hoof down enough H2O I can keep it away.. I can manage this in the winter but always forget in the summer. I played golf in the sunshine last Monday in Wales and forgot my water bottle. It flared up and by Thursday it was bad and Friday worse . I tried to ignore it on Friday and played football on it. Big mistake I know I have to sit still put no weight in it and let it calm down, drink like a fish and it will go away quicker.. So now I can't walk this weekend. What I find odd,is not a single one of the other comments has mentioned drinking tons of water to try and combat it. Maybe I am just weird and have a strange variety of it, But if this helps just one person on the planet, you are very welcome Tom@ttca.co.uk if anyones in the same boat as me and wants to talk about it and swop ideas

Hi I also have palmer, planter psoriasis I had light treatment which worked really well about three years ago . I am very careful of my feet and hands and look after by still using 10% flexitol urea cream and filing and evenings I use hemp foot cream and hand cream ( body shop) I find this seems to keep at bay, also use intensive aveeno cream . Other psoriasis also now coming out especially in hair, I’ve had psoriasis since a child and still like the old coal tar creams which seem to work for me. Hope that’s of some help for someone

Hello everyone, I recently joined and saw this forum/discussions on PPP. I have suffered with psoriasis since my late teens and have recently (am now 61) been diagnosed with PPP. My feet aren't bad but my hands are awful, painful, red inflamed, itchy, cracked, deep cuts appear in exactly the same place on both hands, peeling shedding skin. Last week, I couldn't open my hands. Have been using Dermovate as the dermotologist said to. I am awaiting PUVA treatment to start (apparently I'm on a waiting list for it). I apply Zerobase about every hour, then put latex-free gloves on for most of the day or my hands dry out and make it worse. I have read up on ppp, it seems it is linked to smoking (I have never smoked), and possibly nickel allergy. I was told by a previous dermotologist I have a nickel allergy as my psoriasis was extremely bad on my lower stomach & sides (where the nickel zip & studs were on my jeans) so I am being careful around nickel & foods with high nickel content. Has anyone else got a nickel allergy and link to ppp? And am wondering if the PUVA treatment will help?

My husband has PPP (diagnosed x2 years ago and has been awful has been on cyclosporin and now acetretin) and is on Acetretin at the moment. His Acetretin has been cut by half recently due to problems with his kidney function (10mg from 20mg per day). He is getting pain in his left hip area, he says not necessarily at the hip joint. Has anyone else had this happen after reducing Acetretin. He is waiting to see the Nephrologist with blood tests, ultrasound scan results but he is having real problems with his mobility. Also he has problems with his ears externally, cracked and bleeding ... he is applying creams but nothing seems to be working. Does anyone have any suggestions please?

53 and have had this for about 6 months now. On Acitretin which doesn't really seem to have helped so going on a biologic soon (assuming I've passed screening). Currently hands are terrible with pustules everywhere and deeply cracked palms. Also have aching on underside of forearms from wrist to elbow in the morning which possibly points to psoriatic arthritis - sausage digits too when it flares. Flares seem to be an every two week thing at the moment. My palms are like I've come off my bike and landed on my hands with no gloves.

@cookie re the hip pain it could be referred pain from feet - I get aches when I have a flare in my feet and hands. As to ears I don't think there's anything specific other than what you've probably already used. Probably a thick 40%+ paraffin emolient would be best as it will stay put. Be careful with steroids there because skin is very thin so you'll get a lot of absorption, use very sparingly.

Curious about how this condition affects hands. As I posted above I get regular flares where it's like my outer skin has become a pair of gloves and separated from what's underneath. I can literally leave a dent in my fingertips because it's like there's an air pocket underneath. Eventually all this thick skin cracks and peels off leaving nice clear pink skin underneath. No itching no cracking etc. But if I grip anything or use my hands normally I get an intense prickly and itchy sensation particularly in my palms which takes about ten minutes to subside. Takes huge willpower not to claw at my palms or fingers or to clench my fists hard to try and change the sensation. If I do that I know I'm rapidly on the way to another flare. Any tips on calming this down? I use Cetraben and Hydromol ointment regularly along with sparing use of Betnovate once every other day. I'm waiting to start on a biologic (Humira as it happens!) as PUVA failed and Acitretin seems to have caused hair and nail loss.

Hi folks, Glad to have found this forum - I was diagnosed last week and the advice and stories here are invaluable already. My PPP came on back in January, so about four months ago. I had just moved to a new rental and soon noticed and felt the painful scaling on my feet and hands - I presumed I had caught something environmental from the previous tenant from the carpet and surfaces and since it looked like what was described as athletes foot on a Google image search, I self medicated for a month with over the counter antifungal cream and spray. After nearly a month of no improvement and some days where I couldn't walk without pain, I asked for and luckily got an emergency GP appointment. The first doctor prescribed me more antifungal cream for another month which didn't work. The second GP prescribed a stronger antifungal cream but was not convinced that it was a fungal infection at all - he thought it was PPP and requested an urgent appointment with the dermatologist - my appointment came through for six weeks later and in the meantime I still had to keep taking the stronger antifungal cream (containing the steroid clobetasone at a fairly strong dose) - the week prior to my dermatologist appointment six weeks later I was crippled with the pain from the scaling and deep fissures that had developed on my feet (to a lesser degree on my hands but still painful enough for me to keep dropping things). Throughout this period, it's somewhat fortunate that I have taken a career break for unrelated personal reasons as I don't believe I would have been able to sustain a work life in the condition I got to prior to meeting with the dermatologist - I am very fortunate that my husband was around to do all the shopping, dog-walking, cleaning etc. and help me to the toilet and to bathe. The dermatologist confirmed PPP immediately via a visual assessment only. She talked me through a few medication options which included oral ciclosprorin, but was hopeful that I would see immediate improvement with application of Dermovate cream daily for the next 6 weeks at which point I have another appointment with her. She asked my family history of skin conditions and arthritis - I confirmed no skin conditions that I'm aware of but yes, my mother had very bad arthritis (among other comorbidities), and father had a relentless history of cardiovascular disease and treatment including a heart bypass. She could see my medical records showed that a few months prior to the PPP developing, I had undergone an extended treatment of tetracycline for an aggressive breast abscess and had been diagnosed with extremely high blood pressure during this process too so I'm now taking an ace inhibitor (not a beta blocker), and she insisted that there is nothing I could have done to prevent this happening (since I had been so worried for so long that I had a fungal infection). Prior to the breast abscess, I had undergone significant psychological stress over a number of years and so at first, I put all my medical issues down to stress as the trigger, including the PPP. However, on reading the scientific literature and forums like this over the past week, I'm now postulating if the trigger was the high doses of tetracycline and blood pressure tablets shocking my immune system and subsequent inflammatory response. Incidentally, after the breast abscess, I went cold turkey on smoking cigarettes having been a fairly heavy smoker for over 25 years, so there could also be a link there in that the sweat glands on my palms and soles had been saturated with nicotine having immediately stopped smoking at the same time I was put on the tetracycline and blood pressure tablets. These are presumptions of course but I do have a science background so am surmising this from the patterns I see in both my PPP journey, the scientific papers and forum posts describing people's own experiences I have read, and do believe there is some strength to these conclusions. I have also had referred pain to my right hip joint due to my gait changing to compensate for the pain when walking which has exacerbated an old injury where I tore a ligament at the base of my spine five years ago. Within two days, the once daily application of the clobetasol cream (clobetasol not clobetasone, clobetasol is a stronger steroid) has already started to work as the dermatologist said it would and I've been able to walk my dog for the first time in two weeks. I am combining this with use of prescribed Zerobase emollient a few times a day and have reflected on increasing the amount of antiinflammatory foods I consume. Psychologically, I'm already feeling much better and hopeful that this will last. When I see the dermatologist again in six weeks time, I will be asking her opinion regarding the tetracycline and blood pressure tablets as a causal factor and will report back here then. In the meantime, I hope my journey has been useful information for others who are out there suffering this terribly debilitating auto immune disease - I for one am very grateful to have found this forum so early. All the best for now.xxx

Hi Houdini Good to hear treatment is finally working for you. I've had PPP since last September. Minimal risk factors for me so it was somewhat out of the blue. My feet spontaneously cleared in early March and I maintain them with Dermovate and Diprosalic every other day. Still have some plaques on the heel (like a horseshoe) but they're not that painful and I'm out of my wheelchair and walking short distances. Like you my partner has been doing everything for me for months otherwise I'd have been in hospital. My hands are still sore and permanently under gloves. I found Acitretin and heavy emollients were making them worse so I've stepped back to Calendula and Doublebase gel which seems to be improving things.. I've been on a Humira biosimilar since early March but I'm not sure it's working yet. I still have a lot of plaques - knees, upper arms, lower legs, buttocks and lower back. Consultant is thinking I might need to swap to something more focused so just waiting on biopsy results. Best of luck with your recovery, let us know how it's going.

Hi Kiloran, Many thanks indeed for your speedy response to my post and your good wishes. I have been trawling these forums for information and advice and noticed that you in particular have supported and encouraged so many, including myself - I'm very grateful. Just finding this forum has already made me feel ten times better and much less alone in this; even if our experiences differ somewhat, there is commonality and genuine empathy. Thank you again and I will indeed keep the forum updated. All the very best.xxx

Hiya Houdini/all... This is the most valuable resource eh... Personal experience has such detailed info... I've had PPP for about 9 years now, on the arches of my feet mostly but my hands will break out too, fortunately just on my palms and the side of my hands. I smoke all of the cigarettes still, agh... But I feel that my PPP started when I had a miscarriage which then brought on menopause. My condition flares when I eat sugar I think... And/Or wheat... And different foodstuffs will cause flares in different places, chocolate definitely affects my hands, wheat, my feet... I saw a dermatologist once aand was relieved when she said she'd had this once too, omg I said, and what did you think caused yours?.... She said Caused?? Well, I just had it, and then it went... She hadn't explored the reasons why... Mine doesn't disable me, for which I'm lucky, but my feet are horrendous, I get no constructive help, just a cortisone cream... I wish there were clinical trials which I could join, to further understand. I also really wish that I could stop smoking. Anyway fellow sufferers, I'm so sorry that you have this but so grateful for your insights. Good luck and much love to you all x